Prevalence of colistin resistance in clinical Klebsiella pneumoniae isolates: a systematic review and meta-analysis

Klebsiella pneumoniae commonly causes nosocomial infections, and the rise of colistin-resistant strains poses a significant challenge to public health. This research aims to assess the worldwide prevalence of colistin resistance in K. pneumoniae isolates through a systematic review of scientific literature. We conducted a systematic literature review of relevant studies available in the PubMed, Scopus, and Web of Science databases up to December 2023. Following this, a meta-analysis was performed using Stata software to determine the overall prevalence of colistin resistance in K. pneumoniae isolates and to conduct subgroup analyses. This meta-analysis reviewed 682 studies and found a global prevalence of colistin resistance at 13% among all K. pneumoniae isolates. Notably, the data shows an increase in colistin resistance from 6% in 2010 to 18% in 2023. This study presents evidence of a substantial global prevalence of colistin resistance among clinical isolates of K. pneumoniae. It is recommended to conduct regular surveillance and testing for colistin resistance to effectively monitor and address this public health issue. Klebsiella pneumoniae has increasingly become resistant to various infections, with colistin often regarded as the last line of defense against these resistant strains. The emergence of colistin-resistant isolates poses a significant threat to public health. In this study, we aimed to assess the global prevalence of colistin resistance among K. pneumoniae isolates. We conducted a comprehensive review of relevant studies across three scientific databases, analyzing a total of 682 studies to determine the prevalence of colistin resistance. Our findings reveal a global prevalence rate of 13% for colistin resistance in K. pneumoniae isolates. Notably, this rate has risen from 6% in 2010 to 18% in 2023.To effectively monitor and combat this growing public health concern, we recommend regular surveillance and testing for colistin resistance in clinical settings.